Brent Matthew McLeod, D.P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6051 Issued in OR

Practice address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Phone

(630) 296-2223

Fax

(630) 759-9510

NPI assigned

Sep 18, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kab Physical Therapy LLCGroup PAC ID 7214116839, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kab Physical Therapy LLC

  dba Impact Physical Therapy of Hillsboro

  • Physical Therapist
  • Hillsboro, OR
  • NPI 1447568183
  Medicare reassignment Care Compare group NPD
• Advanced Orthopedic Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • Newberg, OR
  • NPI 1861737769
  Medicare reassignment NPD
• Dimond Physical Therapy and Performance Lab, LLC

  dba The KOR

  • Physical Therapist
  • Beaverton, OR
  • NPI 1184864365
  NPD
• Impact Physical Therapy, LLC

  • Physical Therapist
  • Grants Pass, OR
  • NPI 1083655260
  NPD (past)
• Therapeutic Associates Inc

  dba TAI - Rock Creek

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD (past)
• Therapeutic Associates Inc

  dba TAI Cedar Hills Physical Therapy

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1689908949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 DEBORAH RD",
            "address_2": "STE 190",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971323075",
            "telephone_number": "503-662-6403",
            "fax_number": "503-395-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "BRENT",
        "middle_name": "MATTHEW",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-18",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "6051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON L&I",
            "identifier": "0254307",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01216092",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500618581",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danika Marie McGandy, M.S., BCBA
• Hajar McHabcheb, DMD
• David Robert McHugh, DPT
• Holly McIlvain, PHARMD
• Lauren McLean, NP
• Denise McNicholas, LCPC
• Jessica Meacham, ATC
• Meher Bala Medavaram, M.D.
• Medic Home Health Care, LLC
• Medical Home Care Inc

• Physical Therapist in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.